Predictive Factors for the Healing of Rotator Cuff Repairs

Abstract

INTRODUCTION Rotator cuff tears (RCTs) are a significant cause of shoulder pain. Rotator cuff repair is common, but healing failure is frequent and the reasons for the retear are still unclear. OBJECTIVE This study aimed to determine if specific preoperative factors related to patients and tears affect the structural outcome after rotator cuff repair. METHODS This is a multivariate prognostic model study, based on prospectively collected data from a retrospective cohort. We included individuals who received arthroscopic RCT repair from January 2013 to April 2022. Evaluations were performed using magnetic resonance imaging (MRI) at 12 months postoperatively, and clinical outcomes were measured using the American Shoulder and Elbow Surgeons (ASES) scale. Statistical analysis was conducted using multivariate logistic regression. RESULTS The sample included 176 patients, with a retear rate of 35.2%. Male (p=0.029), smoking (p=0.026), full-thickness infraspinatus tears (p=0.007), and instability of the long head of the biceps (p=0.046) were identified as predictive factors for non-healing. Traumatic lesions (p=0.017) favored healing. All patients showed significant clinical improvement. At 24 months, patients with healed tendons had better clinical outcomes. CONCLUSION Male sex, smoking, full-thickness infraspinatus tears, and instability of the long head of the biceps are predictive factors for retear after rotator cuff repair. Traumatic lesions favor tendon healing.